| 1 | Clinical benefit of left atrial appendage closure in octogenarians显示文摘OBJECTIVES Whether left atrial appendage closure(LAAC)in octogenarians yield similar net clinical benefit compared to younger patients,was the purpose of the present study.METHODS Two real-world LAAC registries,enrolling 744 consecutive Amplatzer and Watchman patients from 2009 to 2018,were retrospectively analyzed.RESULTS All events are reported per 100 patient-years.Two hundred and sixty one octogenarians and 483 non-octogenarians with a mean follow-up of 1.7±1.3 and 2.3±1.6 years,and a total of 1,502 patient-years were included.Octogenarians had a higher risk for stroke(CHA2DS2-VASc score:5.2±1.2 vs.4.3±1.7,P<0.0001)and bleeding(HAS-BLED score:3.3±0.8 vs.3.1±1.1,P=0.001).The combined safety endpoint of major periprocedural complications and major bleeding events at follow-up was comparable(30/446,6.7%vs.47/1056,4.4%;hazard ratio[HR]=1.2;95%confidence interval[CI]:0.73−1.98;P=0.48)between the groups.The efficacy endpoint of all-cause stroke,systemic embolism,and cardiovascular/unexplained death occurred more often in octogenarians(61/446,13.7%vs.80/1056,7.6%;HR=7.0;95%CI:4.53−10.93;P<0.0001).Overall,octogenarians had a lower net clinical benefit,i.e.,the composite of all above mentioned hazards,from LAAC compared to younger patients(82/446,18.4%vs.116/1056,11.0%;HR=4.6;95%CI:3.11−7.0;P<0.0001).Compared to the anticipated stroke rate,the observed rate de-creased by 41%in octogenarians and 53%in non-octogenarians.The observed bleeding rate was reduced by 10%octogenarians and 41%non-octogenarians.CONCLUSIONS LAAC can be performed with similar safety in octogenarians as compared to younger patients.On the long-term,it both reduces stroke and bleeding events,although to a lesser extent than in non-octogenarians. | Yamen Mohrez Steffen Gloekler Steffen Schnupp Wasim Allakkis Xiao-Xia Liu Monika Fuerholz Johannes Brachmann Stephan Windecker Stephan Achenbach Bernhard Meier Caroline Kleinecke | 2021 | Journal of Geriatric Cardiology2021，18，11： | 0 |
| 2 | Microenvironmental effects on growth response of Pinus massoniana to climate at its northern boundary in the Tongbai Mountains,Central China显示文摘The Tongbai Mountains is an ecologically sensi-tive region and the northern boundary of Pinus massoniana Lamb.To analyze the effect of different microenvironments on tree growth response to climate factors,we developed standard chronologies for earlywood width(EWW),late-wood width(LWW),and total ring width(TRW)of P.massoniana at two sampling sites on slopes with different orientations,then analyzed characteristics of the chronolo-gies and their correlations with climate variables from five stations in the region and with a regional normalized differ-ence vegetation index(NDVI).Statistical results showed that the TRW/EWW/LWW chronology consistency and charac-teristics(mean sensitivity,signal to noise ratio,expressed population signal)for trees growing on the southeastern slope were much higher than for trees on the northeastern slope.Correlations indicated that temperature in current March and August has a significant positive effect on TRW/EWW/LWW formation,and the effect on the northeastern slope was weaker than on the southeastern slope.Compared to temperature,precipitation has more complicated effects on tree growth,but the effect on the northeastern slope was also generally weaker than on the southeastern slope.Step-wise linear regression analyses showed that temperature in August was the main limiting factor at the two sampling sites.Similarly,the response of tree growth on the southeast-ern slope as determined by the NDVI is better than on the northeastern slope,and the TRW/EWW/LWW chronologies for the southeastern slope explained over 50%of the total NDVI variances in June.Overall,the results indicate that the difference in the climate response of P.massoniana at two sampling sites is clearly caused by differences in the microenvironment,and such differences should be properly considered in future studies of forest dynamics and climate reconstructions. | Jianfeng Peng Jiayue Cui Jinbao Li Meng Peng Yongtao Ma Xiaoxu Wei Jinkuan Li Xuan Li Yamen Liu Jiaxin Li | 2024 | Journal of Forestry Research2024，35，1： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员